HomeMy WebLinkAbout1318 ~ 1'~'~0245
D~cla~ation ot Domiail• and Citis~nsl~lp ~
TO THE STATE AND COUNTY TAX ASSESSOR,
sT. tunE cour~nr, aoRicA:
Thi: is my dsclaration of Oomicile and Citiunship in ths State of Norida that I am filinq this day in aooo~dano~ ~nd
in aoRformily with Chapbr 222. Section 222.17, Florida Stariitas.
Oaceois Indiana
I was formerly a lepal roside~t of
(Gity)
and 1 rosided at ~ute 2 . Howwsr I have chsn~sd my domi~k
(Stnet and Number) -
ro and am and have baen a bona fide ~esident of t~e Staro of florida sinoe AuK 1 ~ ~y ~
, 19 68, snd I roside at 905 Mid~vay Road _
(Straet and Numbsr)
FORT N~C~, SAlNT LUCIE COUNTY, ELOR~A •
and this statement i: b bs taken as my dedaration of atizenship, adual legal residenoe and domicile in the Stats of Horida.
p~sert hero any pe~tinent fads, such as sale of property or business, or relinquishment of employme~t
at formar domicile, ?emoval of family to new domidle, purchasr of home, ett.)
Placing children in school
.
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i RJRTHER CHtTiFY that 1 will aomply with all other roquiremsnn of a le~al r~ideM of fhb Stst~.
1 FURTHER CERTIFY that I have no intention to ~etum to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT UKIE COUNTY, FLORIDA, permanently.
?
~ . . (Name) Ruth Saatp t
_ ~ • - , ~
~ ~ ~ ~ . (Address)
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,
~ bth Se tember 68
3wom~
to.qnd subscribed before me this day of ~ y 19 .
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Cl~RK C~C!!IT Notary Public
By D.C. My Commission expiros
R~ b~ .oaaMrd M drpNcal. aed oei~&~ fi{.d whh Cl~k c.in~i~ cowt, •nd dopliea~. will~ Tax A««.o~.1
~ 173 PA~1~9 - ,
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